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Siberian Scientific Medical Journal

2020 year, number 1

MORPHOLOGICAL SUBSTANTIATION OF SOMATIC COMPLICATIONS DURING USE OF CEMENT IN KNEE AND HIP JOINT REPLACEMENT

Dmitriy Viktorovich ZHUKOV1, Ivan Vasilyevich RYBALKO2
1Novosibirsk State Medical University of Minzdrav of Russia
zhukdv@ngs.ru
2State Novosibirsk Regional Clinical Hospital
Keywords: цементное эндопротезирование, суставы, метилметакрилат

Abstract

Cement in joint replacement remains the main treatment method for patients with injuries and diseases of major joints. It allows eliminating patient’s pain, correcting the axis and length of the limb, to restore the supportability of the limb and return the patient’s activity. At the same time, it is a very complex treatment method, which requires careful preparation and a rather long postoperative rehabilitation period. Cement prosthetics are most often used in elderly patients with osteoporosis, and, as a rule, with the presence of comorbidities that complicate surgical treatment, and occasionally prevent its implementation. The study of morphological changes occurring in organs and tissues is a necessary step in the study of pathogenesis. Thorough knowledge of these processes allows to develop pathogenetically based methods of prevention or to choose the most appropriate method of treatment. This determined the purpose of the study: on the basis of morphological, experimental data to study the features of somatic and cognitive complications that occur during cement endoprosthetics of the knee and hip joints. An experimental model (95 Wistar rats) of a femur fracture was used to study the effects of intramedural administration of methyl methacrylate. The results were studied after 1 hour, after 1, 3, 7, 30 days. Histological studies (preparations of the femur, brain tissue, heart, lungs, liver, kidneys) were carried out according to standard methods. The results indicate the combined nature of the effects on the body: there is mechanical damage, thermal effects and toxic effects of the methyl methacrylate monomer. The experiment showed that «bone cement implantation syndrome» is not limited only to impaired function of the cardiovascular and respiratory systems, as well as data on impaired renal function, liver, and signs of postoperative cognitive dysfunction.